Archive for category: Disease

Information and news about disease category

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Can the Infectious Disease Yaws Be Eradicated?

Can the Infectious Disease, Yaws, be Eradicated SoonYaws is a relatively unknown disease in the developed world, but in poor tropical areas of Africa, Asia, Latin America and the Western Pacific, it is common and can lead to disfigurement and disability.

Yaws is the most common endemic treponematoses, a group of bacterial infections that also includes nonvenereal syphilis and pinta. All of these infections are transmitted through non-sexual contact with an infected person. They can cause skin lesions, bone pain, bone lesions, nose deformities and the thickening or cracking of a person’s hands and soles of the feet. The World Health Organization (WHO) estimates that 75% of infected people are under 15 years of age, with most cases seen in children aged 6 to 10. Gender is not a determining factor of infection.

Yaws is spread through skin-to-skin contact, usually after a small injury occurs, something common when children play. Yet, WHO states that “overcrowding, poor hygiene and socioeconomic conditions facilitate the spread of the yaws.”

The disease is not life-threatening, which is likely why it became a neglected disease in the scope of global disease work. But if left untreated, a person can become permanently disfigured and disabled. Such a diagnosis is bad for anyone infected with the disease, but since mostly children suffer from yaws, it becomes a life-long issue if not resolved quickly. When a child contracts yaws, their ability to go to school is jeopardized. If left untreated, absenteeism rises among children and their future employment, especially feeding their families through farming, is impacted.

It has long since been thought that yaws could be a disease that can have complete eradication since humans are the only carriers of the disease. Previously, initiatives to eradicate yaws were undertaken with almost complete success. But the mass effort was prematurely lifted and the disease returned, though not quite on the same scale as before.

Recently, the idea of complete eradication has come back up. The two most effective antibiotics to treat yaws are azithromycin and benzathine penicillin, both of which can be given with relative ease. Even though no vaccine is available for yaws, if early diagnosis is achieved, treatment with the antibiotics can occur and sanitation can be improved to help stop the spread of the disease. With the steps, the end of yaws is in sight.

There have already been cases of previously endemic countries achieving complete eradication, including India. The Yaws Eradication Programme (YEP) was launched in India in 1996 with the goal to have complete eradication in the country. In 1997, 735 cases of yaws were reported; in 2004, the country was considered to have achieved “Zero Case.” Because not all cases of yaws are reported, only time will tell if complete eradication can be sustained, but right now all signs are pointing to success.

With great things already happening in India and a plan in place to achieve more success globally, yaws should be eradicated from remaining endemic countries by 2020.

– Megan Ivy

Sources: PubMed.gov, WHO 1, WHO 2
Photo: Chacha

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Mind Over (or at Least on Par with) Matter for HIV Patients

HIV_Patients
HIV-positive individuals face enormous challenges, in terms of both size and quantity, and the psychosocial aspect of their plight is often underestimated.

Living with the stigma of being someone who is “infected” can interfere with opportunities, relationships and one’s overall position in society. Many individuals living with the diagnosis face issues ranging from anxiety to suicidal thoughts, from personality disorders to substance abuse.

Feeling the reality of mortality, along with the sudden ostracism from the community that a person once belonged to due to the stigmatized nature of HIV, is enough to bring up these issues for anyone.

While the war against the physical symptoms and spread of the diseases is in full force, the psychological issues faced by sufferers are just as important to address.

While these “side effects” are not always taken into consideration as a priority, the World Health Organization itself “recommends that attention to the psychosocial needs of people with AIDS should be an integral part of HIV care,” according to a National Institutes of Health (NIH) study. Globally, there are many cases where it is being done with great effectiveness.

Microcredit programs provide small loans to people who, due to their life-threatening diseases and discrimination (despite legislation seeking to prevent it), are hard-pressed to receive them from other places. In the case of the Positive Partnership Program in Thailand, loans are provided for partnerships between one HIV-positive and one HIV-negative person.

Infected individuals who received loans through this program reported feeling a greater sense of self-efficacy, increased acceptance in the community and an overall improved outlook on life. HIV-negative individuals who participated in the program reported an increased understanding of HIV and decreased levels of anxiety, fear and discomfort toward HIV-positive individuals.

Programs like this one are exemplary in the move toward integrating HIV-positive individuals into the rest of society. This is on top of the opportunity they offer them to reach and prove their full mental and economic potential, as, in the study’s period of 2004-2006, 91% of the loans given were repaid on time.

Projects similar to this one include a study of a cognitive-behavioral-group program for HIV-positive men in Hong Kong, and another done in rural Uganda using interpersonal psychotherapy. Both of these studies showed that psychosocially-based programs were effective in reducing symptoms of depression and increasing overall mental health.

In truth, the efforts of groups that work to reduce stigma and increase quality of life are incalculably important. As lecturer in ethics and HIV prevention Bridget Haire says, “showing the nation how people living with HIV are a vibrant, vital and productive part of our community cannot be overestimated.”

Perhaps even more poignant are the words spoken by one of the participants in the Thai Positive Partnership Program: “Life is much improved. My social life is back. I may have HIV, but I am still a human being. I have my self-esteem, and my honor.”

– Em Dieckman

Sources: UNAIDS, NCBI, The Conversation
Photo: Flickr

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Improving Vaccine Shelf Life

Vaccine-Shelf-LifeIt is hard enough to find vaccines for the world’s deadliest diseases, but scientists also grapple with another concern: shelf life.

In order for vaccines to remain potent, they must be kept within a range of suitable temperatures. For instance, they are rendered useless in excessive heat.

The effects of such temperature fluctuations can be substantial. According to the global health nonprofit PATH, the cholera vaccine Dukoral has a shelf life of 36 months when stored at temperatures between 2-8 degrees Celsius. If stored at 27 degrees Celsius, the vaccine will only last 14 days.

This poses a problem for those performing vaccinations in the developing world; in countries near the equator, the heat can be stifling. That means vaccines could expire when they are needed most.

Compounding the problem is the lack of electricity in certain regions. With high temperatures and no reliable way of keeping supplies cold, many vaccines go to waste.

At Intellectual Ventures Lab, scientists are developing a new device to keep vaccines at the ideal temperature, as part of their Global Good program. The Arktek, a passive vaccine storage device, is able to keep vaccines cold for a month with no electricity. It uses the same techniques to remain protected from extreme temperatures as employed by spacecrafts.

The device was put to the test during the recent Ebola outbreak. When health care workers started to test Ebola vaccine candidates, they needed a way to keep them cold during transport and storage.

The vaccines were required to be kept between -60 and -80 degrees Celsius, well below the usual temperature range of the Arktek device. However, with some quick modifications and carefully conducted tests, the container was modified to support such low temperatures.

That meant scientists could prolong the shelf life of experimental Ebola vaccines, if only for a few days longer.

– Kevin McLaughlin

Sources: Intellectual Ventures Lab, PATH, World Health Organization
Photo: Science Museum

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Breeding Superbugs

SuperbugsResearchers have been tracking the increase of the global spread of antimicrobial-resistant infections, also known as superbugs. But the reason for this increase surprised the researchers — drug co-pays seem to have increased superbugs.

Superbugs are defined as “strains of bacteria that have changed (or mutated) after coming into contact with an antibiotic. Once this happens, these bacteria are ‘resistant’ to the antibiotic to which they have been exposed, which means the antibiotic can’t kill the bacteria or stop them from multiplying.”

Many individuals may suggest going back to a doctor and receiving a new prescription for a different antibiotic. But in the developing world, many individuals cannot afford the co-pays for multiple doctor visits, let alone the cost of multiple antibiotic prescriptions.

With the rising costs of prescriptions, many individuals are turning to informal or black markets for their prescriptions. The pills that they buy from black markets may be lower quality, prescribed inappropriately or dosed incorrectly. All of these factors can lead to the spread of superbugs.

According to an analysis of data from 47 countries published in the Lancet Infectious Disease Journal, the amount people spend out-of-pocket on healthcare has turned out to be a better predictor of antibiotic resistance than poverty, sanitation or livestock production.

In the first major report last year, the World Health Organization (WHO) has called antibiotic resistance “a growing public health threat.” This report, which tallied the level of antibiotic resistance in each country, warned that “many of the available treatment options for common infections in some settings are becoming ineffective.”

According to the Centers for Disease Control, each year superbugs cause 2 million people in the United States to become sick, killing 23,000. With the advanced healthcare available in the United States, what effects do superbugs have on the developing world?

With the WHO report in mind, researchers from Stanford University in California and Gandhi Medical College & Hospital in India set out to determine whether the levels of resistance in low and middle income countries were linked to the direct healthcare costs that patients pay.

The researchers found that in countries where patients paid a higher share of healthcare costs, there was a higher level of antibiotic resistance. But this was also only evident in countries that charge co-payments for prescriptions.

While this data does not prove that higher prescription costs cause greater antibiotic resistance, it does show that the two are linked.

Co-payments are usually used to discourage people from seeking unnecessary healthcare but are currently having the opposite effect. With higher co-payments, patients that cannot afford the cost must look elsewhere for their prescriptions: the black market.

Not only are patients endangering themselves with unknown prescriptions and doses, but they are also enabling antibiotic resistance. There needs to be a change so that patients are able to receive needed antibiotics at a reasonable price. If not, antibiotic resistance will become a major problem in the future.

– Kerri Szulak

Sources: ABC Health & Wellbeing, Bloomberg Business
Photo: Live Science

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Ascariasis: A Major Health Problem in the Developing World

Ascariasis

Throughout the developing world, one kind of disease remains more common than any other: worms. In fact, according to The Huffington Post, recent figures have suggested that nearly every person residing in a developing country has some form of worm infection, due to the abundance of worm larva in soil all over the world.

While there are a variety of these infections, one in particular called ascariasis, or ascaris, has become so widespread that, according to the Center for Disease Control, it “account[s] for a major burden of disease worldwide.” In total, 807 million to 1.2 billion people around the world are infected with this parasitic illness, which is also classified as a neglected tropical disease.

It is caused by the consumption of its eggs, which reside in contaminated soil. This happens when fingers that have touched contaminated soil are put in the mouth or if produce has not been properly washed, cooked and peeled.

After ingestion, the eggs make their way to the intestine, where they hatch into larva. The freshly spawned larvae then wait to develop into fully mature worms. An adult female worm can grow up to around 30 cm in length while in the intestine, all while producing eggs that will then return to the soil via the host’s feces.

Upon reaching maturity, these adult worms wiggle through the intestinal wall and make their way towards their host’s lungs through the blood stream. This is where things get even more disgusting. Once near the lungs, they reside by the back of the throat, where they once again lay their eggs and continue the cycle.

Sufferers often do not experience any symptoms, but some of the most common signs of the disease are abdominal pain, coughing, difficulty breathing and fever. In more severe cases, excessive worm growth can cause intestinal blockages. As the worms migrate to the lungs, they are also one of the most common causes of Asthma in the developing world.

Ascariasis can stunt the growth of young children and this age group is also its most common target. When children play in the soil they expose themselves to risk of infection when putting their fingers in their mouths afterward. While usually not lethal, ascaris takes the lives of 60,000 annually, most of which belong to children.

In order to combat this disease, the World Health Organization and many other international aid organizations have attempted mass de-worming efforts. Using the two drugs albendazole and mebendazole, these groups have made progress by treating whole communities.

Another effective way of preventing ascaris does not involve drugs at all and instead relies on health education. These campaigns teach those in afflicted areas how to keep a sanitary kitchen and how to consume food safely, without the risk of catching the disease.

While treatment efforts are ongoing, less than 40 percent of the world’s children in need of treatment have not actually received any. This accounts for more than 850 million children worldwide and stands as one of the largest public health issues in the world. In order to improve the lives of millions, deworming campaigns must carry on.

– Andrew Logan

Sources: The Center for Disease Control, The Deccan Herald, The Huffington Post, The New York Times, The World Health Organization
Photo: Flickr

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India Pushes to Eliminate Elephantiasis Epidemic

Elephantiasis
Lymphatic Filariasis (LF), better known as Elephantiasis, is a painful and profoundly disfiguring disease and yet is a fairly common occurrence in poverty-stricken India. In fact, nearly half of India’s population, about 553 million people, is at risk of contracting LF.

In recent years there has been a mass drug administration (MDA) to people living in the poorest communities of the country. This initiative has been created to stop not only LF, but also many other preventable, chronic and debilitating infections known as neglected tropical diseases (NTD).

However, LF is still one of the most particularly challenging NTDs India has yet to face. Although almost half of India’s population is at risk of becoming infected, LF is one of the easiest NTDs to prevent. This could potentially lead to India eliminating LF within the next few years, and the government has increased efforts by launching the largest MDA in the world.

Yet, there has been little change, for most of the members of the poor Indian communities have been unwilling to take the free medicine. This unwillingness is due to little education, lack of disease awareness and risk perceptions, coupled with general public suspicion of the government distribution program.

Over the last 10 years, advances have led to new diagnostic and treatment tools, along with control strategies for dealing with LF. In October 2014, the Indian Ministry of Heath and Family Welfare (MOHFW) launched a communications campaign known as “Hathipaon Mukt Bharat” or “Filiaria Free India” to create and spread awareness about LF and the new tools to diagnose, treat and prevent the spread of the disease.

The initial campaign was a success, leading to a significant spike in people taking the medicine. With nearly 200,000 health workers in 14 of India’s states providing the information and medicine, the MOHFW was able to reach out to over 300 million people.

Today, India has revitalized its efforts with MOHFW’s Hathipaon Mukt Bharat campaign and has continued to work toward eliminating the LF issue. Recently, the Hathipaon Mukt Bharat initiative won a Silver Lion at the Cannes Lions International Festival of Creativity, earning it national praise for the work it has achieved and will continue to achieve within India.

– Alysha Biemolt

Sources: Impatient Optimists, WHO, JPGM Online, MedInd
Photo: Imagekb

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Cuba’s Mother-to-Child Transmission Victory

mother_to_child_transmission

This past week, Cuba has been a hot topic in the media. News about bridged U.S.–Cuba relations has taken over the news circuit. But Cuba has also recently reached a public health milestone in the fight against AIDS. Cuba has virtually eliminated HIV and syphilis mother-to-child transmission.

Health officials in the country credit a combined task force from the World Health Organization and the Pan American Health Organization. These organizations implemented programs aimed at improving prenatal care, sexually transmitted infection and HIV testing for pregnant women and their partners, treatment for mothers and babies, Cesarean section deliveries and substitutes for breastfeeding. These services were provided through a universal healthcare system to increase accessibility and affordability, two huge components of any health-related intervention program.

Worldwide, over 1.4 million women with HIV become pregnant, which if untreated, puts 15 to 45% of their babies at risk of infection at birth. However, by providing antiretroviral medicines to pregnant women and children after birth, the risk of transmission to their children can be reduced to a mere 1%. Reducing transmission rates is largely a case of improving accessibility and affordability. Through Cuba’s integration of maternal and child health programs with HIV and sexually transmitted infection programs, they can combat the problem on all fronts. By providing services through a universal health system, more women from varying income levels and geographical locations were able to take advantage of them.

The success brings hope in a long fight against HIV/AIDS. The case in Cuba is an encouraging step towards eradicating AIDS, despite not having a cure. The success also serves as an example for countries around the world to analyze and model programs after in their individual battles against the AIDS epidemic. The evidence supporting universal healthcare has gained new support from the Cuba’s success and as other countries continue to try to reduce transmission rates, they may be more compelled to imitate Cuba.

– Emma Dowd

Sources: CNN, Global Research, Time, Washington Post
Photo: Time

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A New “Leash” on Life: India’s Stray Dogs

India’s_Stray_Dogs

While the nation of India has found its own new lease on life as it begins to become heavily industrialized, the furry members of its society are facing some new challenges.

For decades India has struggled with the issue of stray animals, and while cows and elephants are considered holy and treated with respect, the dogs and cats of India are facing a much harder time in their attempts to stay alive.

According to the World Health Organization, there are around 18,000 reported cases of rabies every year in India. In order to remedy this, India’s government had called for the euthanization of India’s stray dogs; however, after much discussion, the Animal Welfare Board of India (AWBI) has asked many states to hold off on this action and attempted to vaccinate the stray animals against several diseases. Essentially, the AWBI believes that such actions taken against these animals is inhumane, as there is no clear distinguishing factor that determines whether an animal should be put down or vaccinated.

When walking the streets of India, it is very common to see dogs and cats roaming around, but travelers are advised not to pet them or interact with them, as they often find food in waste piles and are thus highly prone to disease and infection. However, many residents have been taking care of these animals for years; these animals are thought to have migrated over along with the original inhabitants of the land, thus creating a very blurry line as to which animals are stray and which have been domesticated. The issue with the current laws is that there is no defining point at which an animal becomes a family member and at which point it is still a stray. Many animal rights groups working alongside citizens have been fighting for this distinction to be made.

For now, the AWBI is advising the government to hold off on any euthanization or vaccination tactics that may be used to reduce the stray animal population. Some experts have proposed the idea of neutering definitively stray dogs and cats, so as to reduce the population. Many experts have made it clear that the key to reducing this issue is to better understand the animals themselves and their behavior. Most healthy animals will not bite or scratch a human unless they feel threatened, so a better understanding of animal behavior will allow citizens to express proper caution when dealing with them.

While the government of India remains at a standstill, citizens and animal rights groups have begun to press for better adoption systems and more definitive lines as to an animals ownership. Euthanization of these animals is effectively going against the Indian Supreme Court ruling against the killing of animals, and harm and cruelty toward animals. Many petitions and protests have been held against this action, but no decision has been reached. There is still a long road ahead for these furry friends, but it looks like there may be a light at the end of this very long tunnel.

– Sumita Tellakat

Sources: CNN, BBC
Photo: CNN

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The Debilitating Effects of Schistosomiasis

The Debilitating Effects of Schistosomiasis-TBP
Among neglected tropical diseases, few are harder to pronounce than Schistosomiasis, a parasitic infection spread through fresh water. Fewer still are more deadly. According to the Center for Disease Control, “In terms of impact, this disease is second only to malaria as the most devastating parasitic disease.” Currently, Schistosomiasis infects more than 200 million people worldwide.

Found mostly in Africa and parts of South America and Asia, Schistosomiasis, or bilharzia, is quite an unpleasant disease. It spreads through parasitic blood flukes, also known as schistosomes, which live in certain types of fresh water snails. These schistosomes are tricky creatures and infect their victims with their larvae simply through skin contact in contaminated fresh water.

Once inside the victim’s body, the larval schistosomes mature over the course of several weeks into adult flatworms. These worms then make their way to the victim’s blood vessels where they reach full maturity and mate, producing eggs. The eggs then exit the body through the victim’s urine and stools. From there, the cycle begins again.

Oddly enough, it is not the worms themselves that cause problems but the body’s reaction to the eggs. On their way out of the body, many of the eggs become stuck in the intestine and bladder, which leads to inflammation and scarring of vital organs.

While the short-term symptoms of bilharzia are similar to that of the flu, its long term effects cause much more damage. Chronic bilharzia can cause bladder cancer, infertility and the enlargement of the liver and abdomen. It remains unknown as to how many die annually from the disease but estimates range between 20,000 and 200,000 people.

However, most victims of this neglected tropical disease continue to live for years with it. For chronic sufferers, life becomes increasingly difficult. In fact, the economic consequences of bilharzia rival its health complications. Sufferers often are too debilitated to support themselves and essentially become disabled. It has the greatest impact on children. Youth that suffer from chronic bilharzia experience stunted growth and learning difficulties, which can lead many to drop out of school. Unsurprisingly, due to its economic burden, researchers have linked instances of Schistosomiasis with poverty.

Fortunately, an effective treatment called praziquantel can rid the body of the parasite and cure the disease. Best of all, it is cheap. One treatment of praziquantel costs about 20 to 30 cents and is often available free of charge in some heavily afflicted regions of Sub-Saharan Africa. In 2012, 35 million people were treated for bilharzia with this drug.

With such a cheap and effective drug, the primary strategy of the World Health Organization (WHO) is that of mass treatment without even an individual diagnosis. These mass treatments focus on vulnerable communities like those that live and work near fresh water sources and also school children. In some areas with lower levels of transmission, many officials believe that they can eradicate this disease.

Other methods of prevention involve stopping bilharzia at its source: its freshwater snail hosts. Some efforts have aimed to focus on killing the host snails by using chemical treatments on fresh water sources. However, this has negative effects on surrounding animals and also must be continued to prevent snails from returning. Beyond medicine, the best form of prevention is simply adequate hygiene and sanitation.

While the victims of bilharzia have begun to receive more treatment, a large amount of work still remains. According to a recent WHO epidemiological record, about 40 million people received treatment for Schistosomiasis, which represents only 12.7% of the population requiring preventative treatment measures for Schistosomiasis globally. With medicine so effective, it is tragic that so many should go untreated.

– Andrew Logan

Sources: CDC, The End Fund, NCBI, WHO 1, WHO 2
Photo: Carter Center

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What is Being Done for Human African Trypanosomiasis

Sleeping-Disease
Human African Trypanosomiasis (HAT), also known as Sleeping Disease, is prevalent in Sub-Saharan Africa, affecting rural, poverty-stricken populations with close to 10,000 new cases each year. There are 2 strands of the disease: East African Trypanosomiasis and West African Trypanosomiasis. Both strands are only spread in rural Africa via the bite of tsetse flies and cause similar symptoms, but the incubation periods and medications used are slightly different.

A tsetse bite infects the patient with a parasite, which then lives in the host’s lymphatic system and blood stream. There is also a chance that a pregnant woman can pass the infection on to her child. HAT can cause headaches, fever, weakness, joint pain, stiffness and irregular sleep patterns in its first stages. When the infection advances and crosses over into the host’s nervous system, psychiatric disorders, seizures, coma and death can occur.

The East African strain, named for the region that it is typically found, is the least common of the two with only a few hundred people becoming infected each year. This strain moves particularly fast, though, as patients see symptoms within 1-3 weeks and, if left untreated, death can occur within a few months. This strain is also a bit harder to control, as it is a zoological disease—several animals are able to host the parasitic strain.

The West African strain is the most common with 7,000-10,000 new cases reported each year. This strain can be hard to detect because symptoms can take up to a few months to surface and death can occur after the patient has been infected for several years. This strain, even with its prevalence, can be easier to contain, as humans are the primary hosts of infection. Effective treatment of infected humans will help stop the spread of the disease.

There are medications to help people combat the disease, but different medications are used depending on the stage of infection. Detection can be difficult and the medicine can be expensive, which makes treatment less accessible to those infected, as they reside primarily in rural areas. Spinal taps must be administered to ensure that the disease has not breached the central nervous system, which would cause the treatment plan to change. Even after a patient is considered cured, he or she must undergo routine screening, including a spinal tap, for up to two years. Even with precautions in place, relapse remains possible.

Even with few infected tsetse flies and a relatively small number of cases, the disease saw a resurgence of new cases after several years of latent activity. Nevertheless, the number of new cases are once again reducing every year; reports to the World Health Organization (WHO) have gone from 300,000 in 1995, down to just over 17,000 in 2004, below 10,000 in 2009 and only 7,139 in 2010.

Unfortunately, there is no vaccine available for HAT and recovery from a case does not result in immunity, yet progress is being made.

The WHO has taken great measures to aid African countries that are considered endemic: “technical assistance, access to diagnosis, training [and] access to treatment.” When these areas are focused on, things improve. Access to treatment has been a priority for the WHO because the medicine used for the second stage of the West African strain is an arsenic derivative. New treatments are being worked on to reduce the need for medicines that are accompanied by detrimental side effects.

Not every tsetse fly carries the disease, but the higher number of bites a person gets increases a person’s chance of becoming infected. The Centers for Disease Control (CDC) tells U.S. travelers to wear protective clothing when traveling in rural African areas with lots of brush, wear neutral colors that do not attract the flies, inspect vehicles for flies, avoid bushes, and use insect repellent. Repellent does not guaranteed protection against the tsetse fly, but it will help.

This disease’s resurged because it was ignored for a time. With the CDC’s suggestions and the WHO’s work in the field, the disease could become virtually non-existent in a short time if the decline seen in recent years continues. The medication used will help people gain their lives back and once again become productive members in their society. With all the good work being done to get rid of HAT, this disease could become a thing of the past in rural sub-Saharan communities.

– Megan Ivy

Sources: CDC, WHO, PLOS
Photo: the journal.ie